Oxidative Stress Status in Post Stroke Patients: Sex Differences

Abstract

After a cerebral stroke insult, there is an overproduction of Reactive Oxygen Species (ROS), which overcome the antioxidant defenses, causing further tissues damage. The status of oxidative stress in stroke patients over time, particularly in those undergoing rehabilitation treatments, has been poorly investigated. We analyzed the oxidative stress status in 61 subacute stroke patients (33 females and 28 males) admitted to our rehabilitation center by measuring, in serum: hydroperoxides levels (d-ROMs), antioxidant activity (BAP test), and the relative antioxidant capacity (OSI index). We also analyzed patients for glucose levels and lipid profile. In addition, we analyzed the correlation between oxidative stress status biomarkers and motor deficits, disability, and pain. Almost all patients showed high or very high levels of d-ROMs, while BAP levels were apparently in the reference range of normality. Females had lower BAP values (females: 2478 ± 379; males: 2765 ± 590; p = 0.034) and lower OSI index (females: 5.7 ± 1.9; males: 6.8 ± 1.9; p = 0.043). Moreover, in the male group, the correlation with motor impairment and disability showed a worsened motor performance when oxidative stress is higher. Female group, on the other hand, had an unexpected different trend of correlation, probably due to an unbalanced systemic oxidative stress. Further research is needed to see if sex differences in oxidative stress status in subacute stroke patients persist after rehabilitation.

Keywords: Oxidative Status Index (OSI); antioxidant defense; hydroperoxides; oxidative stress; rehabilitation; stroke.

Figure 1

d-ROMs and BAP levels in healthy subjects [28] and post stroke patients divided by sex. *** p < 0.001 according to the t-test.

Figure 2

Pie charts representing the percentage of patients with oxidative stress severity in the whole group (n = 61), and in female patients (n = 33) and male patients (n = 28). Ranges are represented from normal to very high levels by means of d-ROMs test on serum. Normal (250–300 UCARR); Borderline (301–320 UCARR); Low level (321–340 UCARR); Middle level (341–400 UCARR); High level (401–500 UCARR); Very High level (>500 UCARR).

Figure 3

Pie charts of the percentage of patients with antioxidant status value in the whole group (n = 61), and in female patients (n = 33) and male patients (n = 28). Ranges are represented from optimum status to very high deficiency status measured by means of BAP test on serum. Optimum status (>2200 µmol/L); Borderline status (2200–2000 µmol/L); Slight deficiency status (2000–1800 µmol/L); Deficiency status (1800–1600 µmol/L); High Deficiency Status (1600–1400 µmol/L); Very high Deficiency Status (<1400 µmol/L).